Active NPI
Sean Gerard Connolly, PH.D.
- Clinical Psychologist
- San Antonio, TX
National Provider Identifier
1447321492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21215
- Practice address
- 6800 Park Ten Blvd.,
Suite 298 West
San Antonio, TX 78213 - Phone
- (210) 737-2039
- Fax
- (210) 737-1396
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21215 | TX | Primary |
Addresses
Primary practice location
6800 Park Ten Blvd.,
Suite 298 West
San Antonio, TX 78213
Mailing address
6800 Park Ten Blvd.,
Suite 298 West
San Antonio, TX 78213
Phone (210) 737-2039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21215 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1447321492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 PARK TEN BLVD.,",
"address_2": "SUITE 298 WEST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78213",
"telephone_number": "210-737-2039",
"fax_number": "210-737-1396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 PARK TEN BLVD.,",
"address_2": "SUITE 298 WEST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78213",
"telephone_number": "210-737-2039",
"fax_number": "210-737-1396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "SEAN",
"middle_name": "GERARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "21215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.